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AUGUST IS…

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2011- 2012
The biennial 2011 ranking of America’s 100 Greatest Courses is ready for its close-up.
And for the first time in the list’s history, it has something completely different: 101 courses.
We had a tie at No. 100, which left us no choice but to make room for an
odd number of courses for the first time. Established in 1966, the game’s oldest ranking,
this list is considered the leading symbol of golf-course excellence and integrity.

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PLAYERS PICK THEIR TOP 10

 1. AUGUSTA NATIONAL GC (AUGUSTA, GA.)

Augusta National GC
Tournament: The Masters;
 Designers: Alister Mackenzie and Bobby Jones; Rating: 8.96
Anonymous pro comments: “Best we play on a yearly basis.” … “Only reason it’s not a 10: too manicured, too many [Tom] Fazio changes.” … “It was a 10 when Jack won in 1986, but they’ve added too much length.” … “I think the course is too gimmicky, yet there’s no other tournament in the world I would rather play in.”

2. HARBOUR TOWN GL (HILTON HEAD ISLAND, S.C.) 

Harbour Town GL
Tournament: The Heritage
 Designer: Pete Dye; Rating: 8.7702
Anonymous pro comments: “My favorite Pete Dye course” … “the best course we play.” … “don’t need length for a great golf course” … “It’s a 10 because of great greens.” … “you have to shape the ball on almost every hole.”

3. RIVIERA CC (PACIFIC PALISADES, CALIF.)

Riviera CC
Tournament: Northern Trust Open;
 Designers: George Thomas and Billy Bell; Rating:8.7687
Anonymous pro comments: “Classic” … “You have to hit all the shots,” at a course several called the “best design on the tour” … a property “all the people building newer courses should go look at” … “outside of the sixth hole with the silly bunker in the green, Riviera is perfect.”

4. PEBBLE BEACH GL (PEBBLE BEACH, CALIF.) 

Pebble Beach GL
Tournament: AT&T Pebble Beach Pro-Am;
Designers:
Jack Neville and Douglas Grant;Rating: 8.56
Anonymous pro comments: “Favorite place on earth” … “no better scenery with just a great mix of holes and shots” … “Great course, but it’s never in good shape the time of year we play it,” … “Never a 10 until they fix 14 green” … “Never gets old. Excited to play it every time.”

 5. COLONIAL CC (FORT WORTH, TEX.)

Colonial CC
Tournament: Crowne Plaza Invitational;
 Designers: John Bredemus and Perry Maxwell;Rating: 8.40
Anonymous pro comments: “A great golf course,” a “lot of fun to play” and for one player, “the best layout I’ve ever seen.” … Nos. 3-5 earned raves, with one player calling the fifth “one of the best par 4s we play on tour.” … “Could still lose trees, especially the ones they keep to prevent us from hitting it too far” … “so solid” because “you know what you’re going to get.”

 

6. MUIRFIELD VILLAGE GC (DUBLIN, OHIO)

Muirfield Village GC
Tournament: The Memorial;
 Designer: Jack Nicklaus; Rating: 8.34
Anonymous pro comments: “Immaculate”…has a major feel to it”…”when you are playing well, [there is] no more fun course to play & I think that’s the ultimate compliment”…”the best-conditioned course on tour every year.”…But another said of Jack’s tinkering, “too much ego: see changes to 17 and 18″…”at the forefront of encouraging more courses to constantly get better in all respects.”

7. SHAUGHNESSY G&CC (VANCOUVER, B.C.)

 

Shaughnessy G&CC
Tournament: RBC Canadian Open;
Designer: Vernon Macan; Rating: 8.29
Anonymous pro comments: “Phenomenal” … “an awesome, amazing course” with “a lot of neat holes” … one player wished “they played here every year,” with praise for the greens and in particular, the bunkers, which are “maintained like Australian bunkers with very little sand in the faces” … “Neat look to the place but way too much rough for such a potentially great design.”

8. ARONIMINK GC (NEWTOWN SQUARE, PA.)

Aronimink GC
Tournament: AT&T National;
Designer: Donald Ross; Rating: 8.25
Anonymous pro comments: “A great, classic course, which we need to play more of” because players “have to work the ball both ways.” … “This is a Ross? Doesn’t feel like it, but still very good.” … “Don’t add length, it’s great the way it is.” … “Sensational course, great conditioning, setup has been good and the crowds energetic, so why again we are leaving to go back to Congressional?”

9. INNISBROOK RESORT – COPPERHEAD (PALM HARBOR, FLA.)

 

Innisbrook Resort (Copperhead)
Tournament: Transitions Championship;
 Designers: Larry and Roger Packard; Rating:8.09
Anonymous pro comments: “Best course we play in Florida” … “nicely designed greens with good undulations” … “Doesn’t feel like you’re in Florida” because of “elevation changes” … “benefits from the neighborhood: Florida swing courses are so mediocre.” … Mostly though, the tour’s finest call it a “good, solid course” because in player parlance, you “can’t fake it out there.”

 

 10. CONGRESSIONAL CC (BETHESDA, MD.)

Congressional CC
Tournament: AT&T National;
Designer: Devereux Emmet; Rating: 8.06
Anonymous pro comments: “Love the shorter front nine, not wild about the back which is just too much golf, too many blind shots and too many forgettable holes.” … Players respect the “history and test” … “Hard, hard, hard, with a good routing, but the 10th hole is the worst par 3 I’ve ever seen.” … “some really good holes and some real dogs.” … Hate the tour’s setup of it, loved what the USGA did, just too bad it was so soft.”

 

Read More http://www.golfdigest.com/golf-courses/2012-01/photos-best-tour-courses#ixzz21vaXbAu5

 

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AUGUST IS…

August is recognized as


National Immunization Awareness Month (NIAM)

 REMEMBER…

ALWAYS CHECK WITH YOUR PRIMARY CARE DOCTOR BEFORE MAKING ANY MEDICAL DECISIONS!

IT’S ALWAYS BETTER TO BE SAFE THAN SORRY!

August is National Immunization Awareness Month. This observance provides

the opportunity to remind the community of the importance of immunization.

Make sure that your family and friends are up-to-date on their immunizations.

In August, parents are enrolling children in school, older students are entering college

and adults and the health care community are preparing for the upcoming flu season.

This makes August a particularly good time to focus community attention on the value of immunization.

Vaccines are responsible for the control of many infectious diseases that were once common

in this country. Vaccines have reduced and, in some cases, eliminated many diseases that

once routinely killed or harmed tens of thousands of infants, children and adults.

The viruses and bacteria that cause vaccine-preventable diseases and death still exist

and can infect people who are not protected by vaccines. Vaccine-preventable

diseases have a costly impact, resulting in doctors’ visits, hospitalizations and premature deaths.

Sick children can also cause parents to lose time from work.

Maintaining high immunization rates protects the entire community by interrupting the

transmission of disease-causing bacteria or viruses. This reduces the risk that UN-immunized people

will be exposed to disease-causing agents. This type of protection is known as community or

herd immunity, and embodies the concept that protecting the majority with safe, effective

vaccines also protects those who cannot be immunized for medical reasons.

See More About:

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Cervical Cancer TreatmentChat w/a Cancer Info Expert About Cervical Cancer

With the FDA approval of the HPV vaccine Gardasil’s use in males, many parents of boys

want to know more about the vaccine, why it is necessary, and what the potential risks

that come with Gardasil.Whether or not to vaccinate your son is a personal decision,

but one that should be informed and based on the medical facts. Researching reputable

health information online and talking to your family pediatrician will help you make the

best decision for you child.

Why Is It Important to Vaccinate Boys with HPV Vaccine?

  • less spreading of HPV
  • hopefully, fewer cases of cervical cancer in women
  • perhaps, a decrease in other types of cancer

Vaccinate your son to save someone else’s daughter from possibly getting cervical cancer down the road — that is certainly one valid perspective. But there are others. You also have to evaluate the psychological trauma that can be caused by having genital warts. They are unsightly and can be a major source of sexual shame and embarrassment. They require medical treatment to remove them (often multiple visits), and there is no cure. In addition, vaccinating isn’t just about genital warts. Studies show an increased association between HPV and the development of many types of cancer, especially oral cancer. We know that anal cancer and penile cancer are also two types of cancer that are directly related to HPV, and the vaccine may provide protection against these associated HPV strains.

FOR MORE INFORMATION CLICK HERE

 

 

The goal of NIAM is to increase awareness about

immunizations across the life span.

Vaccines are one of public health’s greatest triumphs. With the exception of safe water,

no other health strategy, not even antibiotics, has had such a tremendous

effect on reducing disease and improving health.

 Because of nationwide immunization efforts, the occurrence of many

vaccine-preventable diseases has been reduced by more than

99% from the pre-vaccine era. Vaccines have eradicated smallpox, eliminated

wild poliovirus in the U.S. and significantly reduced the number of cases of measles,

diphtheria, rubella, pertussis and other diseases. However,

 the viruses and bacteria that

cause these diseases still exist in the world.  Vaccine-preventable diseases cause millions

of deaths worldwide and tens of thousands of death in the US each year.

Why are immunizations important?


Immunization is one of the most significant public health achievements of the 20th century.

But despite these efforts, today tens of thousands of people in the U.S. still die from vaccine-preventable diseases.

Vaccines offer safe and effective protection from infectious diseases. By staying up-to-date on the recommended

vaccines, individuals can protect themselves, their families and friends and their communities from serious,

life-threatening infections. Who should be immunized?
Getting immunized is a lifelong, life-protecting community

effort regardless of age, sex, race, ethnic background or country of origin. Recommended vaccinations

begin at birth and continue throughout life. Being up to date on the vaccines that are recommended for

infants, children, adolescents, and adults of all ages is critical to protecting ourselves,

our loved ones, and our communities from disease.

When are immunizations given?


Because children are particularly vulnerable to infection, most vaccines are given during the first five to six years of life.

Other immunizations are recommended during adolescent and adult years and, for certain vaccines,

booster immunization are recommended throughout life. Vaccines against certain diseases that

may be encountered when traveling outside of the U.S. are recommended for

travelers to specific regions of t
National Network for Immunization Information

Department of Health and Human Services
Centers for Disease Control an Prevention Search:

Vaccines & Immunizations Vaccines Home > Programs & Tools >

Instant Childhood Immunization Scheduler Instant Childhood Immunization Schedule
for children six years and younger 

Current Childhood and Adolescent Immunization Schedule Parents’ Guide

to Childhood Immunization (detailed information about vaccines and immunization) Vaccines:

The Safe Choice (general vaccine safety information)

Adult Immunization Schedule (vaccines recommended for adults)

Disclaimer: This immunization schedule is based on the 2010 Childhood and Adolescent Immunization

Schedule recommended by the Advisory Committee on Immunization Practices (ACIP), the American

Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP).

This schedule provides generally recommended dates for immunizations based on your

child’s birth date. Some diseases or treatments for disease affect the immune system.

For children with these diseases or for children receiving these treatments,

the recommended immunization schedule may need to be modified.

If you have questions or concerns, consult your child’s physician or other

healthcare professional for advice about your child’s immunization schedule.

This page last modified on January 25, 2010 Content last reviewed on January 25, 2010

Content Source: National Center for Immunizations and Respiratory Diseases Vaccine-Related

Topics Immunization Schedules Recommendations and Guidelines Vaccines & Preventable

Diseases Basics and Common Questions Vaccination Records Vaccine Safety and Adverse Events For Travellers

For Specific Groups of People For Program Managers

Additional Resources Publications News and Media Resources Calendars and Events Education and Training

Programs and Tools Statistics and Surveillance Partners’ & Related Sites About NCIRD Contact CDC

For immunization information, call the CDC-INFO Contact Center at:



English and Spanish
(800) CDC-INFO
(800) 232-4636TTY: (888) 232-6348FAX: (770) 488-4760

Recommended Adult Immunization Schedule —

United States, 2012

Weekly

February 3, 2012 / 61(04);1-7

Each year, the Advisory Committee on Immunization Practices (ACIP) reviews the recommended adult immunization schedule to ensure that the schedule reflects current recommendations for licensed vaccines. In October 2011, ACIP approved the adult immunization schedule for 2012, which includes several changes from 2011. A footnote directing readers to links for the full ACIP vaccine recommendations and where to find additional information on specific vaccine recommendations for travelers is now included. In addition, a Table summarizing precautions and contraindications was added. This table is based on the corresponding table in the 12th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases and is included to provide ready access to key safety information for adult vaccine providers (1).

Changes to the footnote for tetanus, diphtheria, and acellular pertussis (Tdap) and tetanus, diphtheria (Td) vaccines were made to update recommendations. Tdap vaccine is recommended specifically for persons who are close contacts of infants younger than 12 months of age (e.g., parents, grandparents, and child-care providers) and who have not received Tdap previously. Before 2011, vaccination postpartum was preferred for women who had not had a previous adult Tdap dose. However, in 2011, ACIP recommended pregnant women preferentially receive Tdap vaccination during later pregnancy (>20 weeks gestation). Other adults who are close contacts of children younger than 12 months of age continue to be recommended to receive a one-time dose of Tdap vaccine.

Updates to the footnotes and figures also were made for human papillomavirus (HPV) and hepatitis B vaccines based on recommendations made at the October 2011 ACIP meeting. The HPV vaccine recommendation has been updated to include routine vaccination of males 11–12 years of age, with catch-up vaccination recommended for males 13–21 years of age. HPV vaccine also is recommended for previously unvaccinated males 22–26 years of age who are immunocompromised, or who test positive for human immunodeficiency virus (HIV) infection, or who have sex with men.

ACIP also voted in October 2011 to recommend hepatitis B vaccine for adults <60 years of age who have diabetes, as soon as possible after diabetes is diagnosed. In addition, hepatitis B vaccination is recommended at the discretion of the treating clinician for adults with diabetes who are 60 years or older based on a patient’s likely need for assisted blood glucose monitoring, likelihood of acquiring hepatitis B, and likelihood of immune response to vaccination.

A notation was included for zoster vaccine to acknowledge that the vaccine was recently approved by the Food and Drug Administration (FDA) for administration to persons 50 years of age and older; however, ACIP continues to recommend that vaccination begin at age 60 years. The influenza vaccine footnote was revised to specify age indications for the different licensed formulations of trivalent inactivated influenza vaccine (TIV). The footnote for the measles, mumps, rubella (MMR) vaccine was simplified to focus only on routine use of this vaccine in adults; information on use of the vaccine for outbreak control was removed. Readers are referred to the ACIP MMR recommendations and to the ACIP recommendations for the immunization of health-care personnel regarding the use of MMR vaccine in outbreak settings. Additional information on the use of quadrivalent meningococcal conjugate vaccine (MCV4) and meningococcal polysaccharide vaccine (MPSV4) for specific age and risk groups was added. Minor clarifications also were made to the footnotes for HPV vaccine, varicella vaccine, and pneumococcal polysaccharide vaccine (PPSV).

Additional information is available as follows: 1) immunization schedule (in English and Spanish) at http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm; 2) information regarding adult vaccination at http://www.cdc.gov/vaccines/default.htm; 3) ACIP statements for specific vaccines athttp://www.cdc.gov/vaccines/pubs/acip-list.htm; and 4) reporting of adverse events at http://www.vaers.hhs.govExternal Web Site Icon or by telephone, 800-822-7967. This schedule also has been presented to the American Academy of Family Physicians, the American College of Physicians, the American College of Obstetricians and Gynecologists and the American College of Nurse- Midwives for approval and publication in their respective journals.

FIGURE 1. Recommended adult immunization schedule, by vaccine and age group1 — United States, 2012

The figure shows the recommended adult immunization schedule, by vaccine and age group in the United States for 2012. For Figure 1, the bar for Tdap/Td for persons 65 years and older has been changed to a yellow and purple hashed bar to indicate that persons in this age group should receive 1 dose of Tdap if they are a close contact of an infant younger than 12 months of age. However, other persons 65 and older who are not close contacts of infants may receive either Tdap or Td.<br /><br /><br /><br /><br /><br /> The 19-26 years age group was divided into 19-21 years and 22-26 years age groups. The HPV vaccine bar was split into separate bars for females and males. The recommendation for all males 19-21 years to receive HPV is indicated with a yellow bar, and a purple bar is used for 22-26 year old males to indicate that the vaccine is only for certain high-risk groups.<br /><br /><br /><br /><br /><br />

Alternate Text: The figure above shows the recommended adult immunization schedule, by vaccine and age group in the United States for 2012. For Figure 1, the bar for Tdap/Td for persons 65 years and older has been changed to a yellow and purple hashed bar to indicate that persons in this age group should receive 1 dose of Tdap if they are a close contact of an infant younger than 12 months of age. However, other persons 65 and older who are not close contacts of infants may receive either Tdap or Td. The 19-26 years age group was divided into 19-21 years and 22-26 years age groups. The HPV vaccine bar was split into separate bars for females and males. The recommendation for all males 19-21 years to receive HPV is indicated with a yellow bar, and a purple bar is used for 22-26 year old males to indicate that the vaccine is only for certain high-risk groups.

FIGURE 2. Vaccines that might be indicated for adults, based on medical and other indications1 — United States, 2012

The figure shows vaccines that might be indicated for adults, based on medical and other indications in the United States, during 2012. For Figure 2, a new column was added for men who have sex with men (MSM) to note in the figure that MSM is an indication for HPV, hepatitis A, and hepatitis B vaccines.<br /><br /> In addition, the diabetes indication was moved to the same col¬umn as chronic kidney disease to accommodate the new recom¬mendation for hepatitis B vaccination of persons with diabetes.<br /><br /> Because pregnant women not previously vaccinated with Tdap are now preferentially recommended for vaccination with Tdap during later pregnancy (>20 weeks gestation), the yellow bar has been extended across all risk groups.<br /><br /> The HPV vaccine bar was separated into a bar for females and one for males. The bar for females is unchanged from the previous year except that the bar was extended to include HCP to clarify that HCP who are in the recommended age group for receipt of HPV vaccine are recommended for vaccination.<br /><br /> Lastly, the HPV vaccine bar for males was added and indicates that all males through age 26 should be vaccinated if they are immunocompromised, have HIV, or are MSM. However, the age indication is through age 21 for males with or without these risk factors.<br /><br />

Alternate Text: The figure above shows vaccines that might be indicated for adults, based on medical and other indications in the United States, during 2012. For Figure 2, a new column was added for men who have sex with men (MSM) to note in the figure that MSM is an indication for HPV, hepatitis A, and hepatitis B vaccines. In addition, the diabetes indication was moved to the same col¬umn as chronic kidney disease to accommodate the new recom¬mendation for hepatitis B vaccination of persons with diabetes. Because pregnant women not previously vaccinated with Tdap are now preferentially recommended for vaccination with Tdap during later pregnancy (>20 weeks gestation), the yellow bar has been extended across all risk groups. The HPV vaccine bar was separated into a bar for females and one for males. The bar for females is unchanged from the previous year except that the bar was extended to include HCP to clarify that HCP who are in the recommended age group for receipt of HPV vaccine are recommended for vaccination. Lastly, the HPV vaccine bar for males was added and indicates that all males through age 26 should be vaccinated if they are immunocompromised, have HIV, or are MSM. However, the age indication is through age 21 for males with or without these risk factors.

NOTE: The above recommendations must be read along with the footnotes on pages 4–5 of this schedule.

1. Additional information

2. Influenza vaccination

  • Annual vaccination against influenza is recommended for all persons 6 months of age and older.
  • Persons 6 months of age and older, including pregnant women, can receive the trivalent inactivated vaccine (TIV).
  • Healthy, nonpregnant adults younger than age 50 years without high-risk medical conditions can receive either intranasally administered live, attenuated influenza vaccine (LAIV) (FluMist), or TIV. Health-care personnel who care for severely immunocompromised persons (i.e., those who require care in a protected environment) should receive TIV rather than LAIV. Other persons should receive TIV.
  • The intramuscular or intradermal administered TIV are options for adults aged 18–64 years.
  • Adults aged 65 years and older can receive the standard dose TIV or the high-dose TIV (Fluzone High-Dose).

3. Tetanus, diphtheria, and acellular pertussis (Td/Tdap) vaccination

  • Administer a one-time dose of Tdap to adults younger than age 65 years who have not received Tdap previously or for whom vaccine status is unknown to replace one of the 10-year Td boosters.
  • Tdap is specifically recommended for the following persons:
    — pregnant women more than 20 weeks’ gestation,
    — adults, regardless of age, who are close contacts of infants younger than age 12 months (e.g., parents, grandparents, or child care providers), and
    — health-care personnel.
  • Tdap can be administered regardless of interval since the most recent tetanus or diphtheria-containing vaccine.
  • Pregnant women not vaccinated during pregnancy should receive Tdap immediately postpartum.
  • Adults 65 years and older may receive Tdap.
  • Adults with unknown or incomplete history of completing a 3-dose primary vaccination series with Td-containing vaccines should begin or complete a primary vaccination series. Tdap should be substituted for a single dose of Td in the vaccination series with Tdap preferred as the first dose.
  • For unvaccinated adults, administer the first 2 doses at least 4 weeks apart and the third dose 6–12 months after the second.
  • If incompletely vaccinated (i.e., less than 3 doses), administer remaining doses.

Refer to the ACIP statement for recommendations for administering Td/Tdap as prophylaxis in wound management (See footnote 1).

4. Varicella vaccination

  • All adults without evidence of immunity to varicella (as defined below) should receive 2 doses of single-antigen varicella vaccine or a second dose if they have received only 1 dose.
  • Special consideration for vaccination should be given to those who
    — have close contact with persons at high risk for severe disease (e.g., health-care personnel and family contacts of persons with immunocompromising conditions) or
    — are at high risk for exposure or transmission (e.g., teachers; child care employees; residents and staff members of institutional settings, including correctional institutions; college students; military personnel; adolescents and adults living in households with children; nonpregnant women of childbearing age; and international travelers).
  • Pregnant women should be assessed for evidence of varicella immunity. Women who do not have evidence of immunity should receive the first dose of varicella vaccine upon completion or termination of pregnancy and before discharge from the health-care facility. The second dose should be administered 4–8 weeks after the first dose.
  • Evidence of immunity to varicella in adults includes any of the following:
    — documentation of 2 doses of varicella vaccine at least 4 weeks apart;
    — U.S.-born before 1980 (although for health-care personnel and pregnant women, birth before 1980 should not be considered evidence of immunity);
    — history of varicella based on diagnosis or verification of varicella by a health-care provider (for a patient reporting a history of or having an atypical case, a mild case, or both, health-care providers should seek either an epidemiologic link to a typical varicella case or to a laboratory-confirmed case or evidence of laboratory confirmation, if it was performed at the time of acute disease);
    — history of herpes zoster based on diagnosis or verification of herpes zoster by a health-care provider; or
    — laboratory evidence of immunity or laboratory confirmation of disease.

5. Human papillomavirus (HPV) vaccination

  • Two vaccines are licensed for use in females, bivalent HPV vaccine (HPV2) and quadrivalent HPV vaccine (HPV4), and one HPV vaccine for use in males (HPV4).
  • For females, either HPV4 or HPV2 is recommended in a 3-dose series for routine vaccination at 11 or 12 years of age, and for those 13 through 26 years of age, if not previously vaccinated.
  • For males, HPV4 is recommended in a 3-dose series for routine vaccination at 11 or 12 years of age, and for those 13 through 21 years of age, if not previously vaccinated. Males 22 through 26 years of age may be vaccinated.
  • HPV vaccines are not live vaccines and can be administered to persons who are immunocompromised as a result of infection (including HIV infection), disease, or medications. Vaccine is recommended for immunocompromised persons through age 26 years who did not get any or all doses when they were younger. The immune response and vaccine efficacy might be less than that in immunocompetent persons.
  • Men who have sex with men (MSM) might especially benefit from vaccination to prevent condyloma and anal cancer. HPV4 is recommended for MSM through age 26 years who did not get any or all doses when they were younger.
  • Ideally, vaccine should be administered before potential exposure to HPV through sexual activity; however, persons who are sexually active should still be vaccinated consistent with age-based recommendations. HPV vaccine can be administered to persons with a history of genital warts, abnormal Papanicolaou test, or positive HPV DNA test.
  • A complete series for either HPV4 or HPV2 consists of 3 doses. The second dose should be administered 1–2 months after the first dose; the third dose should be administered 6 months after the first dose (at least 24 weeks after the first dose).
  • Although HPV vaccination is not specifically recommended for health-care personnel (HCP) based on their occupation, HCP should receive the HPV vaccine if they are in the recommended age group.

6. Zoster vaccination

  • A single dose of zoster vaccine is recommended for adults 60 years of age and older regardless of whether they report a prior episode of herpes zoster. Although the vaccine is licensed by the Food and Drug Administration (FDA) for use among and can be administered to persons 50 years and older, ACIP recommends that vaccination begins at 60 years of age.
  • Persons with chronic medical conditions may be vaccinated unless their condition constitutes a contraindication, such as pregnancy or severe immunodeficiency.
  • Although zoster vaccination is not specifically recommended for health-care personnel (HCP), HCP should receive the vaccine if they are in the recommended age group.

7. Measles, mumps, rubella (MMR) vaccination

  • Adults born before 1957 generally are considered immune to measles and mumps. All adults born in 1957 or later should have documentation of 1 or more doses of MMR vaccine unless they have a medical contraindication to the vaccine, laboratory evidence of immunity to each of the three diseases, or documentation of provider-diagnosed measles or mumps disease. For rubella, documentation of provider-diagnosed disease is not considered acceptable evidence of immunity.

Measles component:

  • A routine second dose of MMR vaccine, administered a minimum of 28 days after the first dose, is recommended for adults who
    — are students in postsecondary educational institutions;
    — work in a health-care facility; or
    — plan to travel internationally.
  • Persons who received inactivated (killed) measles vaccine or measles vaccine of unknown type from 1963 to 1967 should be revaccinated with 2 doses of MMR vaccine.

Mumps component:

  • A routine second dose of MMR vaccine, administered a minimum of 28 days after the first dose, is recommended for adults who
    — are students in postsecondary educational institutions;
    — work in a health-care facility; or
    — plan to travel internationally.
  • Persons vaccinated before 1979 with either killed mumps vaccine or mumps vaccine of unknown type who are at high risk for mumps infection (e.g., persons who are working in a health-care facility) should be considered for revaccination with 2 doses of MMR vaccine.

Rubella component:

  • For women of childbearing age, regardless of birth year, rubella immunity should be determined. If there is no evidence of immunity, women who are not pregnant should be vaccinated. Pregnant women who do not have evidence of immunity should receive MMR vaccine upon completion or termination of pregnancy and before discharge from the health-care facility.

Health-care personnel born before 1957:

  • For unvaccinated health-care personnel born before 1957 who lack laboratory evidence of measles, mumps, and/or rubella immunity or laboratory confirmation of disease, health-care facilities should consider routinely vaccinating personnel with 2 doses of MMR vaccine at the appropriate interval for measles and mumps or 1 dose of MMR vaccine for rubella.

8. Pneumococcal polysaccharide (PPSV) vaccination

  • Vaccinate all persons with the following indications:
    — age 65 years and older without a history of PPSV vaccination;
    — adults younger than 65 years with chronic lung disease (including chronic obstructive pulmonary disease, emphysema, and asthma); chronic cardiovascular diseases; diabetes mellitus; chronic liver disease (including cirrhosis); alcoholism; cochlear implants; cerebrospinal fluid leaks; immunocompromising conditions; and functional or anatomic asplenia (e.g., sickle cell disease and other hemoglobinopathies, congenital or acquired asplenia, splenic dysfunction, or splenectomy [if elective splenectomy is planned, vaccinate at least 2 weeks before surgery]);
    — residents of nursing homes or long-term care facilities; and
    — adults who smoke cigarettes.
  • Persons with asymptomatic or symptomatic HIV infection should be vaccinated as soon as possible after their diagnosis.
  • When cancer chemotherapy or other immunosuppressive therapy is being considered, the interval between vaccination and initiation of immunosuppressive therapy should be at least 2 weeks. Vaccination during chemotherapy or radiation therapy should be avoided.
  • Routine use of PPSV is not recommended for American Indians/Alaska Natives or other persons younger than 65 years of age unless they have underlying medical conditions that are PPSV indications. However, public health authorities may consider recommending PPSV for American Indians/Alaska Natives who are living in areas where the risk for invasive pneumococcal disease is increased.

9. Revaccination with PPSV

  • One-time revaccination 5 years after the first dose is recommended for persons 19 through 64 years of age with chronic renal failure or nephrotic syndrome; functional or anatomic asplenia (e.g., sickle cell disease or splenectomy); and for persons with immunocompromising conditions.
  • Persons who received PPSV before age 65 years for any indication should receive another dose of the vaccine at age 65 years or later if at least 5 years have passed since their previous dose.
  • No further doses are needed for persons vaccinated with PPSV at or after age 65 years.

10. Meningococcal vaccination

  • Administer 2 doses of meningococcal conjugate vaccine quadrivalent (MCV4) at least 2 months apart to adults with functional asplenia or persistent complement component deficiencies.
  • HIV-infected persons who are vaccinated should also receive 2 doses.
  • Administer a single dose of meningococcal vaccine to microbiologists routinely exposed to isolates of Neisseria meningitidis, military recruits, and persons who travel to or live in countries in which meningococcal disease is hyperendemic or epidemic.
  • First-year college students up through age 21 years who are living in residence halls should be vaccinated if they have not received a dose on or after their 16th birthday.
  • MCV4 is preferred for adults with any of the preceding indications who are 55 years old and younger; meningococcal polysaccharide vaccine (MPSV4) is preferred for adults 56 years and older.
  • Revaccination with MCV4 every 5 years is recommended for adults previously vaccinated with MCV4 or MPSV4 who remain at increased risk for infection (e.g., adults with anatomic or functional asplenia or persistent complement component deficiencies).

11. Hepatitis A vaccination

  • Vaccinate any person seeking protection from hepatitis A virus (HAV) infection and persons with any of the following indications:
    — men who have sex with men and persons who use injection drugs;
    — persons working with HAV-infected primates or with HAV in a research laboratory setting;
    — persons with chronic liver disease and persons who receive clotting factor concentrates;
    — persons traveling to or working in countries that have high or intermediate endemicity of hepatitis A; and
    — unvaccinated persons who anticipate close personal contact (e.g., household or regular babysitting) with an international adoptee during the first 60 days after arrival in the United States from a country with high or intermediate endemicity. (See footnote 1 for more information on travel recommendations). The first dose of the 2-dose hepatitis A vaccine series should be administered as soon as adoption is planned, ideally 2 or more weeks before the arrival of the adoptee.
  • Single-antigen vaccine formulations should be administered in a 2-dose schedule at either 0 and 6–12 months (Havrix), or 0 and 6–18 months (Vaqta). If the combined hepatitis A and hepatitis B vaccine (Twinrix) is used, administer 3 doses at 0, 1, and 6 months; alternatively, a 4-dose schedule may be used, administered on days 0, 7, and 21–30 followed by a booster dose at month 12.

12. Hepatitis B vaccination

  • Vaccinate persons with any of the following indications and any person seeking protection from hepatitis B virus (HBV) infection:
    — sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than one sex partner during the previous 6 months); persons seeking evaluation or treatment for a sexually transmitted disease (STD); current or recent injection-drug users; and men who have sex with men;
    — health-care personnel and public-safety workers who are exposed to blood or other potentially infectious body fluids;
    — persons with diabetes younger than 60 years as soon as feasible after diagnosis; persons with diabetes who are 60 years or older at the discretion of the treating clinician based on increased need for assisted blood glucose monitoring in long-term care facilities, likelihood of acquiring hepatitis B infection, its complications or chronic sequelae, and likelihood of immune response to vaccination;
    — persons with end-stage renal disease, including patients receiving hemodialysis; persons with HIV infection; and persons with chronic liver disease;
    — household contacts and sex partners of persons with chronic HBV infection; clients and staff members of institutions for persons with developmental disabilities; and international travelers to countries with high or intermediate prevalence of chronic HBV infection; and
    — all adults in the following settings: STD treatment facilities; HIV testing and treatment facilities; facilities providing drug-abuse treatment and prevention services; health-care settings targeting services to injection-drug users or men who have sex with men; correctional facilities; end-stage renal disease programs and facilities for chronic hemodialysis patients; and institutions and nonresidential daycare facilities for persons with developmental disabilities.
  • Administer missing doses to complete a 3-dose series of hepatitis B vaccine to those persons not vaccinated or not completely vaccinated. The second dose should be administered 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose). If the combined hepatitis A and hepatitis B vaccine (Twinrix) is used, give 3 doses at 0, 1, and 6 months; alternatively, a 4-dose Twinrix schedule, administered on days 0, 7, and 21–30 followed by a booster dose at month 12 may be used.
  • Adult patients receiving hemodialysis or with other immunocompromising conditions should receive 1 dose of 40 µg/mL (Recombivax HB) administered on a 3-dose schedule or 2 doses of 20 µg/mL (Engerix-B) administered simultaneously on a 4-dose schedule at 0, 1, 2, and 6 months.

**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
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August Is

National Eye Exam Month

Posted by Hugh T. Farley on Wednesday, July 25th, 2012

 

State Senator Hugh T. Farley (R, C, I – Schenectady)

suggests to parents that an eye exam is a good thing to put on the back-to-school supply list.
“This is the time of year when parents start purchasing back-to-school supplies. Why not add an eye exam to the list so your child is fully prepared for school and will be able to see classroom boards and focus better on learning,” Senator Farley said.

Senator Farley reported that August has been designated since 1995 as the month to focus on children’s eye health and safety. This national observance educates parents and educators about the critical link between vision and learning.

Children are more susceptible to UV damage than adults because they tend to spend more time outside than adults. To protect children’s eyes, adults should:
* Buy sunglasses that offer UV protection.

* Make sure sunglasses fit the child’s face, shielding eyes from all angles.

* Choose lenses that are impact resistant and made of polycarbonate, not glass.

* Insist children wear a brimmed hat and sunglasses.
The College of Optometrists in Vision Development reports that 25 percent of students in grades kindergarten through 6th have visual problems that impede learning. An estimated 80 percent of children with a learning disability have an undiagnosed vision problem. A three year study of 540 children found that those with visual perceptual and eye movement difficulties did poorly on standardized tests.

Senator Farley suggests parents work with their pediatricians on finding vision screenings for children before they begin the school year. Or visit the College of Optometrists in Vision Development’s website for more information on this topic at www.covd.org and to locate a developmental optometrist in the area.

Why Have an Eye Exam?

By Mayo Clinic staffAn eye exam helps detect eye problems at their earliest stage — when they’re most treatable. Regular eye exams give your eye care professional a chance to help you correct or adapt to vision changes and provide you with tips on caring for your eyes.When to have an eye exam
Several factors may determine how frequently you need an eye exam, including your age, health and risk of developing eye problems. General guidelines include:
  • Children 5 years and younger. For children under 3, your pediatrician will likely look for the most common eye problems — lazy eye, crossed eyes or turned-out eyes. Depending on your child’s willingness to cooperate, his or her first more comprehensive eye exam should be done between the ages of 3 and 5.
  • School-age children and adolescents. Have your child’s vision checked before he or she enters first grade. If your child has no symptoms of vision problems and you don’t have a family history of vision problems, have your child’s vision rechecked every two years. If your child does have vision problems or a family history of vision problems, have your child’s vision rechecked as advised by your eye doctor.
  • Adults. In general, if you’re healthy and have no symptoms of vision problems, you should have your vision checked every five to 10 years in your 20s and 30s. Between ages 40 and 65, have your vision checked every two to four years. After age 65, get your eyes checked every one to two years. If you wear glasses, have a family history of eye disease or have a chronic disease that puts you at greater risk of eye disease, such as diabetes, have your eyes checked more frequently.

How you prepare

By Mayo Clinic staffThree kinds of eye specialists may perform an eye exam:

  • Ophthalmologists. Ophthalmologists are medical doctors who provide full eye care, such as giving you a complete eye exam, prescribing corrective lenses, diagnosing and treating complex eye diseases, and performing eye surgery.
  • Optometrists. Optometrists provide many of the same services as ophthalmologists, such as evaluating your vision, prescribing corrective lenses, diagnosing common eye disorders and treating selected eye diseases with drugs. But you’ll likely be referred to an ophthalmologist for more complex eye problems and for conditions requiring surgery.
  • Opticians. Opticians fill prescriptions for eyeglasses, including assembling, fitting and selling them. Some opticians also sell and fit contact lenses.

Which specialist you choose may be a matter of personal preference, or one specialist may be best for treating your particular eye concern.

What to expect from your doctor
If you’re seeing a new eye doctor or if you’re having your first eye exam, expect questions about your vision history. Your answers help your eye doctor understand your risk of eye disease and vision problems. Be prepared to give specific information, including:

  • Are you having any eye problems now?
  • Have you had any eye problems in the past?
  • Were you born prematurely?
  • Do you wear glasses or contacts now? If so, are you satisfied with them?
  • What health problems have you had in recent years?
  • Are you taking any medications?
  • Do you have any allergies to medications, food or other substances?
  • Does anyone in your family have eye problems, such as cataracts or glaucoma?
  • Does anyone in your family have diabetes, high blood pressure, heart disease or any other health problems that can affect the whole body?

If you wear contact lenses or glasses, bring them to your appointment. Your eye doctor will want to make sure your prescription is the best one for you. Also be prepared to remove your contacts or glasses for certain exams. Tests that use dye (fluorescein) to temporarily color your eyes may permanently dye your contact lenses, so take them out before those types of tests.

HAVE A HAPPY AUGUST!

 

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